A Comparative Effectiveness Analysis of Three Continuous Glucose Monitors

被引:67
作者
Damiano, Edward R. [1 ]
El-Khatib, Firas H. [1 ]
Zheng, Hui [2 ]
Nathan, David M. [3 ,4 ,5 ]
Russell, Steven J. [3 ,4 ,5 ]
机构
[1] Boston Univ, Dept Biomed Engn, Boston, MA 02215 USA
[2] Massachusetts Gen Hosp, Ctr Biostat, Boston, MA 02114 USA
[3] Massachusetts Gen Hosp, Diabet Unit, Boston, MA 02114 USA
[4] Massachusetts Gen Hosp, Dept Med, Boston, MA 02114 USA
[5] Harvard Univ, Sch Med, Boston, MA USA
基金
美国国家卫生研究院;
关键词
DIABETIC-PATIENTS; INSULIN DELIVERY; TYPE-1; PANCREAS;
D O I
10.2337/dc12-0070
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE-To compare three continuous glucose monitoring (CGM) devices in subjects with type 1 diabetes under closed-loop blood glucose (BG) control. RESEARCH DESIGN AND METHODS-Six subjects with type 1 diabetes (age 52 +/- 14 years, diabetes duration 32 +/- 14 years) each participated in two 51-h closed-loop BG control experiments in the hospital. Venous plasma glucose (PG) measurements (GlucoScout, International Biomedical) obtained every 15 min (2,360 values) were paired in time with corresponding CGM glucose (CGMG) measurements obtained from three CGM devices, the Navigator (Abbott Diabetes Care), the Seven Plus (DexCom), and the Guardian (Medtronic), worn simultaneously by each subject. Errors in paired PG-CGMG measurements and data reporting percentages were obtained for each CGM device. RESULTS-The Navigator had the best overall accuracy, with an aggregate mean absolute relative difference (MARD) of all paired points of 11.8 +/- 11.1% and an average MARD across all 12 experiments of 11.8 +/- 3.8%. The Seven Plus and Guardian produced aggregate MARDs of all paired points of 16.5 +/- 17.8% and 20.3 +/- 18.0%, respectively, and average MARDs across all 12 experiments of 16.5 +/- 6.7% and 20.2 +/- 6.8%, respectively. Data reporting percentages, a measure of reliability, were 76% for the Seven Plus and nearly 100% for the Navigator and Guardian. CONCLUSIONS-A comprehensive head-to-head-to-head comparison of three CGM devices for BG values from 36 to 563 mg/dL revealed marked differences in performance characteristics that include accuracy, precision, and reliability. The Navigator outperformed the other two in these areas. Diabetes Care 36:251-259, 2013
引用
收藏
页码:251 / 259
页数:9
相关论文
共 9 条
[1]   Novel Use of Glucagon in a Closed-Loop System for Prevention of Hypoglycemia in Type 1 Diabetes [J].
Castle, Jessica R. ;
Engle, Julia M. ;
Youssef, Joseph E. L. ;
Massoud, Ryan G. ;
Yuen, Kevin C. J. ;
Kagan, Ryland ;
Ward, W. Kenneth .
DIABETES CARE, 2010, 33 (06) :1282-1287
[2]   Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial [J].
Hovorka, Roman ;
Allen, Janet M. ;
Elleri, Daniela ;
Chassin, Ludovic J. ;
Harris, Julie ;
Xing, Dongyuan ;
Kollman, Craig ;
Hovorka, Tomas ;
Larsen, Anne Mette F. ;
Nodale, Marianna ;
De Palma, Alessandro ;
Wilinska, Malgorzata E. ;
Acerini, Carlo L. ;
Dunger, David B. .
LANCET, 2010, 375 (9716) :743-751
[3]   Comparison of the numerical and clinical accuracy of four continuous glucose monitors [J].
Kovatchev, Boris ;
Anderson, Stacey ;
Heinemann, Lutz ;
Clarke, William .
DIABETES CARE, 2008, 31 (06) :1160-1164
[4]   Continuous subcutaneous glucose monitoring in diabetic patients - A multicenter analysis [J].
Maran, A ;
Crepaldi, C ;
Tiengo, A ;
Grassi, G ;
Vitali, E ;
Pagano, G ;
Bistoni, S ;
Calabrese, G ;
Santeusanio, F ;
Leonetti, F ;
Ribaudo, M ;
Di Mario, U ;
Annuzzi, G ;
Genovese, S ;
Riccardi, G ;
Previti, M ;
Cucinotta, D ;
Giorgino, F ;
Bellomo, A ;
Giorgino, R ;
Poscia, A ;
Varalli, M .
DIABETES CARE, 2002, 25 (02) :347-352
[5]   Blood Glucose Control in Type 1 Diabetes With a Bihormonal Bionic Endocrine Pancreas [J].
Russell, Steven J. ;
El-Khatib, Firas H. ;
Nathan, David M. ;
Magyar, Kendra L. ;
Jiang, John ;
Damiano, Edward R. .
DIABETES CARE, 2012, 35 (11) :2148-2155
[6]   Feasibility of automating insulin delivery for the treatment of type 1 diabetes [J].
Steil, Garry M. ;
Rebrin, Kerstin ;
Darwin, Christine ;
Hariri, Farzam ;
Saad, Mohammed F. .
DIABETES, 2006, 55 (12) :3344-3350
[7]   The Effect of Insulin Feedback on Closed Loop Glucose Control [J].
Steil, Garry M. ;
Palerm, Cesar C. ;
Kurtz, Natalie ;
Voskanyan, Gayane ;
Roy, Anirban ;
Paz, Sachiko ;
Kandeel, Fouad R. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2011, 96 (05) :1402-1408
[8]   Fully automated closed-loop insulin delivery versus sermautomated hybrid control in pediatric patients with type 1 diabetes using an artificial pancreas [J].
Weinzimer, Stuart A. ;
Steil, Garry M. ;
Swan, Karena L. ;
Dziura, Jim ;
Kurtz, Natalie ;
Tamborlane, Williani V. .
DIABETES CARE, 2008, 31 (05) :934-939
[9]   Comparison of a needle-type and a microdialysis continuous glucose monitor in type 1 diabetic patients [J].
Wentholt, IM ;
Vollebregt, MA ;
Hart, AA ;
Hoekstra, JB ;
DeVries, JH .
DIABETES CARE, 2005, 28 (12) :2871-2876